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General NPI Number Information
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NPI Number | 1346397783
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Entity Type | Organization
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Legal Business Name | CHIROPRACTIC COMPANY - 23 LTD
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Dates
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Enumeration Date | 01/05/2007
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Last Update Date | 09/24/2024
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Provider Practice Location Address
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Address Line | 1905 N CALHOUN RD STE 115
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City | BROOKFIELD
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State | WI
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Zip | 53005-5036
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Country | US
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Telephone | 262-782-2273
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Fax | 262-257-9966
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Provider Business Mailing Address
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Address Line | 11131 N WAUWATOSA RD
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City | MEQUON
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State | WI
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Zip | 53097-3431
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Country | US
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Telephone | 414-354-5377
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | JOHN P CORSI
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Credential | DC
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Telephone | 414-354-5377
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 2181
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License Number State | WI
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